NHS white paper advances government's transparency agenda

Many clues as to the way the government will proceed with the NPfIT

The impact of NHS proposals on NPfIT is still not clear

Despite many analysts arguing that the health service should be left alone, health secretary Andrew Lansley’s white paper, Equity and excellence: Liberating the NHS, promises a huge shake-up of NHS processes.

The new system will phase out Strategic Health Authorities and Primary Care Trusts and put GPs in charge of commissioning care for their patients.

This will mean increased reliance on the Choose and Book system, which has been criticised by doctors for being clunky and difficult to use.

The paper does not provide details on how other elements of the NHS National Programme for IT (NPfIT) will progress, but a spokesperson for the Department of Health said that a paper detailing the government's policy on the programme will be released in the next four weeks.

However, there was considerable mention of technology in the white paper. One line as reported by eHealth Insider said that the Department of Health will cut its budgets for centrally managed programmes and that "NHS services will increasingly be empowered to be customers of a more plural system of IT and other suppliers."

This could be interpreted as the dismantling of many of the central elements of the NPfIT as both the Conservatives and Liberal Democrats proposed in opposition; but is more likely to mean simply that the NHS will continue as it has done in recent years to procure technology outside the programme and on a more localised basis.

There was also a promise at the beginning of the report that the new government would deliver an "information revolution" in the NPfIT.

Part of this would be delivered by the management of data and health records, although there was no mention of the controversial Summary Care Records Scheme.

In line with the government’s transparent data agenda, the white paper said it would simplify the process for patients wanting to download their records and pass them, in a standard format, to any organisation of their choice.

Perhaps the most interesting section on information management stated that the government would make aggregate data available in a standard format to allow intermediaries to analyse and present it to patients in an easily understandable way.

It would also make aggregated, anonymised data available to the university and research sectors, giving them the potential to suggest new areas of research through medical and scientific analysis.

However, commentators argue that this aim of being able to provide aggregate data for research is only achievable where there are comprehensive data sets. Wide use of the opt-out clause for retention of personal data will limit the data's research potential.

In addition, Patient Reported Outcome Measures (PROMS), which were introduced under the last Labour government, will be extended across the NHS “wherever practicable”, meaning patients will be able to rate more of the services they receive.